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重新构想向住院医师阶段的过渡:实习生呼吁加快行动。

Reimagining the Transition to Residency: A Trainee Call to Accelerated Action.

作者信息

Lin Grant L, Guerra Sylvia, Patel Juhee, Burk-Rafel Jesse

机构信息

G.L. Lin is a second-year child neurology resident, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, California; ORCID: https://orcid.org/0000-0001-6888-2140 .

S. Guerra is a first-year general surgery resident, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.

出版信息

Acad Med. 2023 Feb 1;98(2):158-161. doi: 10.1097/ACM.0000000000004646. Epub 2022 Mar 8.

Abstract

The transition from medical student to resident is a pivotal step in the medical education continuum. For applicants, successfully obtaining a residency position is the actualization of a dream after years of training and has life-changing professional and financial implications. These high stakes contribute to a residency application and Match process in the United States that is increasingly complex and dysfunctional, and that does not effectively serve applicants, residency programs, or the public good. In July 2020, the Coalition for Physician Accountability (Coalition) formed the Undergraduate Medical Education-Graduate Medical Education Review Committee (UGRC) to critically assess the overall transition to residency and offer recommendations to solve the growing challenges in the system. In this Invited Commentary, the authors reflect on their experience as the trainee representatives on the UGRC. They emphasize the importance of trainee advocacy in medical education change efforts; reflect on opportunities, concerns, and tensions with the final UGRC recommendations (released in August 2021); discuss factors that may constrain implementation; and call for the medical education community-and the Coalition member organizations in particular-to accelerate fully implementing the UGRC recommendations. By seizing the momentum created by the UGRC, the medical education community can create a reimagined transition to residency that reshapes its approach to training a more diverse, competent, and growth-oriented physician workforce.

摘要

从医学生到住院医师的转变是医学教育连续过程中的关键一步。对于申请者而言,成功获得住院医师职位是多年训练后梦想的实现,对其职业发展和经济状况有着改变人生的影响。这些高风险因素导致美国住院医师申请和匹配过程日益复杂且功能失调,无法有效服务于申请者、住院医师项目或公众利益。2020年7月,医师问责联盟成立了本科医学教育-研究生医学教育审查委员会,以批判性地评估向住院医师阶段的整体过渡情况,并就解决该系统中日益增长的挑战提出建议。在这篇特邀评论中,作者们反思了自己作为审查委员会学员代表的经历。他们强调学员倡导在医学教育变革努力中的重要性;反思了与审查委员会最终建议(于2021年8月发布)相关的机遇、担忧和紧张关系;讨论了可能限制实施的因素;并呼吁医学教育界,尤其是联盟成员组织,加速全面实施审查委员会的建议。通过抓住审查委员会创造的契机,医学教育界可以重新构想向住院医师阶段的过渡,重塑其培养更加多样化、有能力且注重成长的医师队伍的方式。

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